Recruiting Questionnaire for Woman's Soccer

Name:     (first)        (last)        (middle in.)

Street Address:   

City:         State:         Zip Code:     

    Home Phone:         Cell Phone:   

Email Address:   

Date of Birth:   

Father's Name:         Occupation:  

Work Phone:   

Mother's Name:         Occupation:  

Work Phone:   

Academic Information:


School Name:   

School Address:   

City:         State:        Zip Code:      

Date of Graduation:   

Guidance Counselor:       Phone:   

Coach:       Phone:   

Class Rank:         Grade Point Average:      S.A.T. - Verbal        Math:   

Academic Honors:


Academic Majors You Are Interested in:   

Do you have an application to Shippensburg University?   Yes No

Have you applied to Shippensburg University?   Yes No  
Have you been accepted to Shippensburg?   Yes No

Have you completed and mailed the NCAA Clearinghouse information?  Yes No

If Yes, what date did you submit your information to the NCAA?  

Athletic Information:


Height:        Weight:        Position:     

Dominant Foot  L R     40 Time:        Team Record:   

Statistics:   Goals     Assists     Shutouts     Goals against Avg  

Uniform Number:      Years Played:        Years Played Varsity  

League/Conference:      Do you have a video available?   Y N

Other Sports Played:  

Awards/Recognitions:


Other Soccer Experience:


Tournament Experience:


Describe any injuries that required professional medical assistance:


Any Additional Information: